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. 2019 May;8(5):2146-2156.
doi: 10.1002/cam4.2110. Epub 2019 Apr 1.

Clinical and histopathological characteristics and survival analysis of 4594 Japanese patients with melanoma

Yasuhiro Fujisawa  1   2   3 , Shusuke Yoshikawa  1   4 , Akane Minagawa  1   5 , Tatsuya Takenouchi  1   6 , Kenji Yokota  1   7 , Hiroshi Uchi  1   8 , Naoki Noma  1   9 , Yasuhiro Nakamura  1   10 , Jun Asai  1   11 , Junji Kato  1   12 , Susumu Fujiwara  1   13 , Satoshi Fukushima  1   14 , Jiro Uehara  1   15 , Toshihiko Hoashi  1   16 , Tatsuya Kaji  1   17 , Taku Fujimura  1   18 , Kenjiro Namikawa  1   19 , Manabu Yoshioka  1   20 , Naoki Murao  1   21 , Dai Ogata  1   22 , Kanako Matsuyama  1   23 , Naohito Hatta  1   24 , Yoshitsugu Shibayama  1   25 , Toshiharu Fujiyama  1   26 , Masashi Ishikawa  1   27 , Daisuke Yamada  1   28 , Akiko Kishi  1   29 , Yoshiyuki Nakamura  3 , Takatoshi Shimiauchi  2   26 , Kazuyasu Fujii  2   30 , Manabu Fujimoto  3 , Hironobu Ihn  2   14 , Norito Katoh  2   11
Affiliations

Clinical and histopathological characteristics and survival analysis of 4594 Japanese patients with melanoma

Yasuhiro Fujisawa et al. Cancer Med. 2019 May.

Abstract

Background: The incidence of melanoma among those of an Asian ethnicity is lower than in Caucasians; few large-scale Asian studies that include follow-up data have been reported.

Objectives: To investigate the clinical characteristics of Japanese patients with melanoma and to evaluate the prognostic factors.

Methods: Detailed patient information was collected from the database of Japanese Melanoma Study Group of the Japanese Skin Cancer Society. The American Joint Committee on Cancer seventh Edition system was used for TNM classification. The Kaplan-Meier method and Cox proportional hazards model were used to estimate the impact of clinical and histological parameters on disease-specific survival in patients with invasive melanoma.

Results: In total, 4594 patients were included in this analysis. The most common clinical type was acral lentiginous melanoma (40.4%) followed by superficial spreading melanoma (20.5%), nodular melanoma (10.0%), mucosal melanoma (9.5%), and lentigo maligna melanoma (8.1%). The 5-year disease-specific survival for each stage was as follows: IA = 98.0%, IB = 93.9%, IIA = 94.8%, IIB = 82.4%, IIC = 71.8%, IIIA = 75.0%, IIIB = 61.3%, IIIC = 41.7%, and IV = 17.7%. Although multivariate analysis showed that clinical classifications were not associated with survival across all stages, acral type was an independent poor prognostic factor in stage IIIA.

Conclusions: Our study revealed the characteristics of melanoma in the Japanese population. The 5-year disease-specific survival of each stage showed a similar trend to that of Caucasians. While clinical classification was not associated with survival in any stages, acral type was associated with poor survival in stage IIIA. Our result might indicate the aggressiveness of acral type in certain populations.

Keywords: Asian; Epidemiology; Japanese; Melanoma; acral; mucosal.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Kaplan‐Meier plots for patients classified according to the AJCC version seventh TNM classification system. Only patients with four clinical types (ALM, SSM, LMM, and NM) and have pathological diagnosis were included in this analysis. Survival curves for (A) all stages; (B) Stages I and II; (C) Stage III; and (D) Stage IV. * P < 0.05, ** P < 0.01, *** P < 0.001
Figure 2
Figure 2
Kaplan‐Meier plots for each stages. (A) Survival curves for stage 0, 1 and 2. (B) Survival curves for stage 3 and 4
Figure 3
Figure 3
Kaplan‐Meier plots for Stage 3A‐3C. *P < 0.05
Figure 4
Figure 4
Kaplan‐Meier plots for Stage 4. Patients who received ICI and/or BRAFi had prolonged survival compared with those who did not. BRAFi, BRAF inhibitor; ICI, immune checkpoint inhibitors. ** P < 0.01
See this image and copyright information in PMC

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